Is Two-Tier Health Care the Future?

Vanessa Gruben B.Sc.H (Queen’s), LL.B. (Ottawa), LL.M. (Columbia) is Vice Dean (Academic), an Associate Professor at the University of Ottawa, Faculty of Common Law and a member of the Centre for Health Law, Policy and Ethics. She also leads the Ottawa Hub for Harm Reduction – a multidisciplinary forum for scholars and community organizations who work on innovative harm reduction strategies. She is also co-editor of the 5th edition of Canada’s leading text on health law and policy in Canada, Canadian Health Law and Policy, co-edited with Joanna Erdman and Erin Nelson (LexisNexis, 2017). Professor Gruben teaches graduate and undergraduate courses in Health Law and a seminar on Access to Health Care.

List of Figures



List of Tables




Introduction
The Courts and Two-Tier Medicare
Colleen M. Flood and Bryan Thomas




Part I: The Context and Contestations of Public and Private in the Canadian Health Care System



1. Private Finance and Canadian Medicare: Learning from History
Gregory P. Marchildon





2. Chaoulli to Cambie: Charter Challenges to the Regulation of Private Care
Martha Jackman




3. Borders, Fences, and Crossings: Regulating Parallel Private Finance in Health Care
Jeremiah Hurley




4. Chaoulli v Quebec: Cause or Symptom of Quebec Health System Privatization?
Amélie Quesnel-Vallée, Rachel McKay, and Noushon Farmanara




5. Experiences with Two-Tier Home Care in Canada: A Focus on Inequalities in Home Care Use by Income in Ontario
Sara Allin, David Rudoler, Danielle Dawson, and Jonathan Mullen




6. Self-Regulation as a Means of Regulating Privately Financed Medicare: What Can We Learn from the Fertility Sector?
Vanessa Gruben




Part II: Is Canada Odd? Looking at the Regulation of Public/Private Mix of Health Care in Other Countries



7. The Politics of Market-Oriented Reforms: Lessons from the United Kingdom, the United States, and the Netherlands
Carolyn Hughes Tuohy




8. The Public-Private Mix in Health Care: Reflections on the Interplay between Social and Private Insurance in Germany
Achim Schmid and Lorraine Frisina Doetter




9. The Public-Private Mix in France: A Case for Two-Tier Health Care?
Zeynep Or and Aurélie Pierre




10. Embracing Private Finance and Private Provision: The Australian System
Fiona McDonald and Stephen Duckett




11. Embracing and Disentangling from Private Finance: The Irish System
Stephen Thomas, Sarah Barry, Bridget Johnston, Rikke Siersbaek, and Sara Burke




12. Contracting Our Way Around Two-Tier Care? The Use of Physician Contracts to Limit Dual Practice
Bryan Thomas




Conclusion
The Complex Dynamics of Canadian Medicare and the Constitution
Colleen M. Flood and Bryan Thomas




Contributors’ Biographies
Acknowlegments
Index